Evaluating readmission rates due to gastrointestinal bleeds in post cardiac catheterization patients at an academic medical center

Abstract

Specific Aims: To determine the proportion of patients placed on dual or triple antithrombotic therapy post-cardiac catheterization who were readmitted for gastrointestinal (GI) bleeds who were discharged on concomitant proton pump inhibitor (PPI)/histamine receptor 2 antagonist (H2RA) therapy. Methods: Retrospective chart review of patients who presented to Banner University Medical Center South Campus (BUMCS) for cardiac catheterization who underwent percutaneous coronary intervention (PCI) from January 1st, 2016 to December 31st, 2016. Discharge medications of those patients were reviewed, with a focus on dual/triple therapy and contaminant gastroprotective therapy. The concomitant use of gastro-protective therapy (PPI/ H2RA) among those patients were identified. Demographics, past medical history, pertinent laboratory values and HAS-BLED score were obtained from the patient’s electronic health record. Main Results: A total of 147 patient charts were reviewed. A total of 133 patients received dual antiplatelet therapy, nine received triple antithrombotic therapy, and five received neither treatment. The patients were separated into two groups: PPI/H2RA or no PPI/H2RA. There was no significant difference between those on gastroprotective therapy (n= 53, 36%) and those not on gastroprotective therapy (n =94, 64%) with concomitant dual/triple antithrombotic therapy (p= 0.94). A total of 31 readmissions, 30-days within stent placement, were found. Among readmissions, one was attributed to gastrointestinal bleeding and was readmitted 11-days after discharge and was on gastroprotective therapy. Conclusions: There was no significant difference of readmissions due to GI bleeding between those on gastroprotective therapy and those not on gastro-protective therapy with concomitant dual/triple antithrombotic therapy as only one GI bleed was found.